Real-Time Dominant Frequency Analysis of the Pulmonary Vein in Patients with Paroxysmal Atrial Fibrillation
Version of Record online: 6 NOV 2011
©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 35, Issue 1, pages 28–37, January 2012
How to Cite
MATSUO, S., YAMANE, T., DATE, T., TOKUTAKE, K.-I., HIOKI, M., ITO, K., NARUI, R., TANIGAWA, S.-I., TOKUDA, M., YAMASHITA, S., INADA, K., MINAI, K., KOMUKAI, K., SUGIMOTO, K.-I. and YOSHIMURA, M. (2012), Real-Time Dominant Frequency Analysis of the Pulmonary Vein in Patients with Paroxysmal Atrial Fibrillation. Pacing and Clinical Electrophysiology, 35: 28–37. doi: 10.1111/j.1540-8159.2011.03259.x
- Issue online: 12 JAN 2012
- Version of Record online: 6 NOV 2011
- Received April 1, 2011; revised August 18, 2011; accepted September 5, 2011.
- atrial fibrillation;
- dominant frequency;
- catheter ablation;
- pulmonary vein isolation
Background: Paroxysmal atrial fibrillation (PAF) can be treated with pulmonary vein isolation (PVI). A spectral analysis can identify sites of high-frequency activity during atrial fibrillation (AF). We investigated the role of the PVs on AF perpetuation by dominant frequency (DF) analysis.
Methods: Thirty-one consecutive patients with PAF who underwent PVI were included in the prospective study. DF was calculated in each of the PVs, 16, five, and five sites in the left atrium, the coronary sinus, and the right atrium, respectively. In patients presenting sinus rhythm at the baseline, AF was induced by pacing. The PVs were then divided into two groups; PVs demonstrated the highest DF (HDF-PV) and others.
Results: One patient was excluded from the analysis because sustained AF could not be induced. AF was terminated in 43.3% (13/30) of patients during ablation. Of 92 PVs isolated during AF, 30 and 62 PVs were classified into the HDF-PV and others, respectively. PAF was more frequently terminated by the HDF-PV isolation compared to the others (33.3%[10/30] vs 4.8%[3/62], P = 0.0004). Interestingly, nine of the 30 HDF-PVs showing the highest DF among all 30 regions, including extra PVs, led to AF termination in 88.9% (eight out of nine) of cases. Moreover, the HDF-PVs isolation resulted in a greater AF cycle length prolongation than the other PVs isolation (12.1±5.0 vs 2.7±7.6 ms, P = 0.007).
Conclusion: Termination of PAF was more frequently observed during ablation of the PVs with the highest DF. The PV showing high DF played an important role in the maintenance of PAF. (PACE 2012; 35:28–37)